We already know what older people want. A study from the National Conference of State Legislatures and AARP, as well as other studies, confirm, time and again, that the vast majority of us want to live in our homes and communities as we age, and, if possible, to avoid dependence on others and institutionalization.
Meeting this deeply personal goal requires that we design and provide good care in our hospitals and clinics, and expand that care beyond traditional boundaries. It requires the involvement of both health care and community-based service providers; a skilled paid workforce; and a well-supported, family-based “care force.” It also, of course, requires the correct blend of policies and funding.
This is an increasingly urgent concern. A person turns sixty-five every eight seconds, and according to Census numbers, the population of people age eighty-five and older, which doubled in the past thirty years, is projected to almost triple to more than 14 million people by 2040.
One obstacle we face is that our country spends almost twice as much on health care as on social services. To enable more older people to get the care and the outcomes they seek, we must find ways to balance our investment between these types of services, work together across sectors, and use our resources in forward-looking ways.
A good framework for this approach can be found in the work of the Institute of Medicine’s Forum on Aging, Disability, and Independence, which I cochair with Fernando Torres-Gil of the University of California, Los Angeles. A collaboration of the National Academies of Sciences, Engineering, and Medicine, the forum provides a critically needed and neutral venue to bring together aging and disability stakeholders from around the country, accelerate the transfer of research to practice and policy, and identify levers of change.